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DPD 2 > Prostate > Flashcards

Prostate Flashcards

1
Q

LUTS symptoms / IPSS questionnaire = international prostate symptom score

A 
Incomplete emptying
Frequency
intermittency
Urgency
Weak stream
Straining
Nocturia
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2
Q

LUTS - more likely to be BPH or cancer?

A

BPH affects urethra more quickly than cancer

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3
Q

Voiding vs storage problems

A 
Voiding = 
Hesitancy
Weak stream
Intermittency 
Incomplete emptying

Storage symptoms:
Frequency
Urgency
Nocturia

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4
Q

What might cause voiding symptoms?

A 
BPH
Urethral stricture (in young men)
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5
Q

What might cause storage symptoms?

A

Detrusor overactivity

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6
Q

Investigations

A 
Frequency volume chart
Haematuria
DRE
Urine flow check 
Urine dpstick
Flow rate
Bladder scan
u and e psa
renal USS
Cystoscopy to check for strictures
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7
Q

What objects are used to estimate sizes of the prostate?

A

Ping pong ball size

Tennis ball

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8
Q

What conservative and medical management

A

Conervative - reassure and advice on fluid intake

Medical:

Alpha blockers - tamsulosin, alfuzosin

5 alpha reductase inhibitors - finasteride, dutasteride

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9
Q

Herbal meds for BPH

A

Saw palmetto

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10
Q

Surgical management for BPH

A

TURP - trans urethral resection of prostate

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11
Q

Other options for managing BPH

A

Laser surgery
Rezum/steam
urolift - stapling lobes of prostate to side
Embolisation (for elderly if not fit for spinal anaesthetic)
Long term catheter

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12
Q

5 alpha reductase inhibitors

A

Finasteride, dutasteride

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13
Q

Alpha blockers

A

Tamsulosin, alfuzosin

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14
Q

Treatment of overactive bladder - conservative

A

Reassure
Bladder training exercises (BAUS)
Dietary advice

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15
Q

Treatment of medical management for overactive bladder

A

Anticholinergics

Beta agonist

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16
Q

Anticholinergics used for overactive bladder

A

Oxybutinin
Tolterodine
Solifenacin

17
Q

Beta agonist used for overactive bladder

A

Betmiga

18
Q

Surgical management of used for overactive bladder

A

Botox to knock out detrusor

But wears off after 6 month

19
Q

Risk factor for prostate cancer

A

Afrocarribean males

BRCA2 genes

20
Q

A PSA over what range gets investigated

A

Anyone with a PSA over 3

21
Q

Causes of raised PSA

A 
BPH
Urinary retention
Infection
Catheter
Prostate cancer
22
Q

What investigation does not cause a raised PSA

A

DRE

23
Q

What is used to GRADE the prostate cancer? What indicates low risk? What indicates high risk?

A

Gleason scoring system
3 + 3 low risk

5 + 5 high risk

24
Q

Investigations for prostate cancer

A

grading
Staging
MRI / bone scan
MDT discussion

25
Q

Active surveillance is used for which patients with prostate cancer?

A

For young men

26
Q

When would you do watchful waiting for prostate cancer? What do you do afterwards?

A

Elderly
Co-morbid patients

Delay hormonal treatment which cuts off testosterone until it is absolutely needed (as it you get menopausal treat

27
Q

Main SE of prostate cancer therapy

A

Erectile difficulties

Incontinence

28
Q

Radical radiotherapy is used for which patients with prostate cancer?

A

Higher PSAs

Older patients

29
Q

Which of these treatments doesn’t actually cure patients?

A

Hormones and chemo doesn’t cure patients

30
Q

Types of hormonal therapy for prostate cancer

A

Antiandrogen - blocks testosterone receptors directly

LHRH agonist - overstimulate pituitary

31
Q

Why are antiandrogens started before the LHRH agonists?

A

Over production of testosterone initially due to LHRH agonistic activity
Causes rapid fall of testosterone
Wh

32
Q

Why are antiandrogens started before the LHRH agonists?

A

Over production of testosterone initially due to LHRH agonistic activity
So if someone has spinal mets, can make it worse
So give antiandrogens first

DPD 2 (22 decks)

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